When I envision the word economy within the special context of writing medical content, the chore of referencing comes to mind. Specifically, to what extent must or should we go in assuring the reader that we speak with authority? Considering the current climate of best evidence synthesis or evidence-based medicine, it seems more necessary than ever to provide readers with a balanced review of pertinent and recent related work. But the more I thought about it, the more I realized that "the economy of writing" was a fairly broad topic so I have endeavored to scribble down some ideas that I would have liked to have known myself 30-some years ago when I started writing technical papers. Technical writing, of course, would include textbooks, chapters in textbooks, and papers in peer-reviewed, indexed scientific literature. The greatest bulk of that is the latter, so I will focus on that undertaking in this chapter.
Numerous factors are believed to influence the risk for injury to the cervical spine in low speed automobile crashes. These include occupant stature, gender, position, age, pre-existing health status, and awareness of impending crash. Factors extrinsic to the occupant that are thought to influence the risk for injury include seat back characteristics, head restraint geometry, type of restraint system used, crash speed, relative vehicle mass, and the direction of impact. Several studies have indicated that rear impact crashes are associated with greater risk for injury and, in some cases, a worse prognosis. Epidemiological studies have identified many risk factors, but the retrospective study design and wide ranging variables of real life crash scenarios has not allowed careful comparison of specific variables. We sought to answer the question concerning the possible reasons for the disparity in risk between front vector crashes and rear vector crashes using human subject crash testing.
Auto insurers use a variety of techniques to control their losses, and one that has been widely employed since the mid-1990's is the Minor Impact Soft Tissue (MIST) segmentation strategy. MIST protocol dictates that all injury claims resulting from collisions producing US dollars 1000 or less in damage be "segmented", or adjusted for minimal compensation.Multiple databases were searched for studies comparing any of three dependent variables (injury risk, injury severity, or duration of symptoms) with structural damage in motor vehicle crashes of under 40 km/h (25 mph).A limited correlation between crash severity and injury claims was found. We could not determine, however, whether this relationship held across all crash severities. Other studies provided conflicting results with regard to acute injury risk, but both found no statistically significant correlation between crash severity and long-term outcome.A substantial number of injuries are reported in crashes of little or no property damage. Property damage is an unreliable predictor of injury risk or outcome in low velocity crashes. The MIST protocol for prediction of injury does not appear to be valid.
In order to investigate the validity of spelling tests against the criterion of an estimate of spelling accuracy in a sample of writing, three tests with differing formats were constructed from a common pool of words. Test `A' was a proof reading/correction test. Test `B' followed a multiple choice/cloze format, and Test `C' was a traditional dictated word test. Following the administration of these tests to three Standard III and three Standard IV classes, a sample of writing was collected. Each written script was ranked independently by three judges on the basis of their interpretation of five written criteria. The mean of the three rankings was calculated, and then transformed into a standard score. To help assess the possible impact of sampling on the results of the study, the Standard III and Standard IV groups were randomly divided into two sub-samples of n = 40. There were no significant differences between the mean scores of the two sub-samples at each class level. The median correlation between the rankings of writing and Tests `A' and `C' (the tests emphasising the production of correct spelling) was greater than the corresponding correlation for Test `B' (the test emphasising the recognition of correct spelling). The results of correcting the correlations for attenuation suggested that variations in reliability of the tests and rankings were not responsible for the relationships that had been found.
Dr. Croft is Director, Spine Research Institute, San Diego; Dr. Freeman is Clinical Assistant Professor, Department of Public Health and Preventive Medicine, Oregon Health Sciences University School of Medicine.
